SSports ports TTrauma and rauma and OOveruse veruse PPrevention revention

STOP Elbow Injuries

Elbow Injuries

• Why are we so concerned about elbow injuries?• Because elbow injuries are…

– Common: >50-75% of youth baseball players– Increasing: Elbow surgery has increased 50% in

high school pitchers in the past 5 years.– Preventable: Fewer pitches = Longer Career

• Only 4 Little League World Series pitchers have made it to the MLB

• Why? Overuse injuries & Early burnout!

Common Elbow Conditions

• Ligament & Tendon Injuries– UCL (Ulnar Collateral Ligament)

• Tommy John

– Medial & Lateral Epicondylitis• Bone & Growth Plate Injuries

– Occur in Growing children– Medial Apophysitis

• “Little Leaguer’s Elbow”

Risk Factors for Elbow Injuries

• Number of Pitches– Pitch Count: #1 Risk Factor for Elbow Injuries– Year round baseball, Multiple teams

• Pitch Types– Fast Ball should be mastered first– ?Breaking pitches should be taught later (>14 yrs)

• Mechanics– Strength supports form, form supports speed– Fatigue leads to poor mechanics

-Lyman, AJSM 2002

Pitch Counts & Rest

Age Pitches/Game

7-8 509-10 75

11-12 8513-16 9517-18 105

Pitch Counts

Age 7-16

Age 17-18

# Rest Days

61+ 76+ 341-60 51-75 221-40 26-50 11-20 1-25 0

Rest Days

-USA Baseball Medical and Safety Advisory Committee

When To Throw What

• Fastball First• Change-up Second• Breaking Pitches

– Curveball, Slider– After age 14?

• Learn one pitch at a time

Pitch AgeFastball 8±2

Change-up 10±3Curveball 14±2

Knuckleball 15±3Slider 16±2

Forkball 16±2Screwball 17±2

-USA Baseball Medical and Safety Advisory Committee

Diagnosing Elbow Overuse

• Pain is NOT a sign of a strength deficit.• Common Symptoms

– Loss of form, accuracy, or velocity– Takes longer to loosen up– Early Fatigue– Pain– Stiffness– Swelling

-USA Baseball Medical and Safety Advisory Committee

Treating Elbow Overuse

• Prevention is the best treatment!

• Initial Treatment– Rest, Ice, Gentle stretching

• Involve your coach early• When to see a doctor…

– Pain that lasts more than a few days

– Swelling or stiffness in the joint

Preventing Elbow Injuries

• Watch pitch counts and rest days!• Always warm up & cool down• Learn proper mechanics• Don’t forget strength &

conditioning• No year round play• Avoid multiple teams• Don’t pitch through pain or fatigue

Summary

• Elbow injuries are common & preventable.• Pitch counts are the #1 risk factor for elbow

injuries.• Prevention is the key and rest is the cure.

• Charles Carroll